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University  of  California. 


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A    BULLETIN 


CONDITION   OF  THE  COUNTY 
ALMSHOUSES    OF    MISSOURI 


CHARLES  A.  ELLWOOD,  Ph.  D., 

Professor  of  Sociology 


HI    I^HKD    I'.V    11!!'      DF.PARTMEN 

UNIVERSITY  OF  MISbOURl 
May,  I904' 


'vwwrarehiv'e.drg/d'efarlsyB 


A    BULLETIN 


ON   THE 


CONDITION   OF  THE  COUNTY 
ALMSHOUSES    OF    MISSOURI 


BY 


CHARLES  A.  ELLWOOD,  Ph.  D., 
Professor  of  Sociology 


PUBLISHED  BY  THE    DFPARTMEXT  OF  SOCIOLOGY 

UNIVERSITY  OF  MISSOURI 
May,  1904. 


^^p^ 


A  BULLETIN  ON  THE  CONDITION  OF  THE 
COUNTY  ALMSHOUSES  OF  MISSOURI 


The  Condition  of  The  County  Almshouses  of  Mis- 
souri. 

Statistics,  There  is  but  one  method  of  collecting 
accurate  statistics  concerning  social  conditions ;  and  that 
is  to  send  experts  into  the  field  to  gather  the  informa- 
tion upon  the  spot.  Unfortunately  this  method  was  not 
open  to  the  department  of  sociology  when  it  undertook 
to  investigate  the  condition  of  the  county  almshouses  of 
Missouri.  The  desired  information  had  to  be  obtained 
by  other  and  less  accurate  means.  Wherever  possible 
a  student  or  alumnus  of  the  University  was  sent  to 
visit  the  almshouse  about  which  information  was 
sought;  but  it  was  found  possible  to  do  this  in  only 
about  thirty  per  cent,  of  the  cases.  In  the  remaining 
cases  question  blanks  were  sent  to  the  superintendents 
of  the  almshouses  with  the  request  that  they  be  filled 
out  and  returned  to  the  department.  In  this  way  infor- 
mation was  received  concerning  fifty  per  cent,  more  of 
the  almshouses.  But  when  no  response  from  the  super- 
intendent could  be  elicited,  the  information  was  usually 
obtained  through  the  county  clerk,  although  in  the  case 


1 59882 


of  three  comity  almshouses  all  efforts  of  every  sort 
failed  to  secm^e  the  desired  information.  Nevertheless, 
in  spite  of  the  relatively  crude  methods  employed  in 
gathering  the  statistics,  there  can  be  no  doubt  that  they 
present  a  fairly  accurate  picture  of  the  actual  condi- 
tions of  Missouri  almshouses  to-day.  Small  details, 
both  good  and  bad,  may  lie  concealed,  but  the  main  out- 
lines of  the  system  stand  out  in  clear  relief. 

The  statistics  here  presented  concern  ninety  of  the 
ninety-three  county  almshouses  of  Missouri.  Twenty- 
one  counties  of  Missouri  have  no  almshouses,  but  still 
follow  the  primitive  practice  of  boarding  out  their  pau- 
pers (usually  very  few  in  number)  with  farmers.  These 
counties  are  Benton,  Camden,  Carter,  Dent,  Douglass, 
Dunklin,  Gasconade,  Hickory,  Laclede,  McDonald, 
Madison,  Maries,  Miller,  Oregon,  Ozark,  Pemiscot,  Rip- 
ley, Shannon,  Taney,  Worth,  and  Wright.  St.  Louis 
county  also  has  no  almshouse,  but  sends  its  paupers  to 
the  St.  Louis  City  Poorhouse. 

The  chief  statistics  for  each  almshouse  of  the  ninety 
concerning  which  information  could  be  obtained  are 
herewith  presented  in  tabular  form,  beginning  on  the 
following  page. 


Religious 
services. . . 


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Cost  per 
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Religious 
services. .. 


Emprym't 
of  able- 
bodied  . . . 


Cells  for 
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By  lease 
system  .. 


Cost  per 
week  per 
inmate 


Expenses 
per  annum 


Cost  of 
buildings  . 


Acres  of 
land    . . . 


Paralytic 


Crippled. 


Blind 


Epileptic. 


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minded . 


Insane.., 


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2  and  14.. 


Under  18 


Between 
18  and  60. 


Above 


Colored. 


White 


Female. 


Male. 


Total. 


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The  total  number  of  inmates  in  the  ninety  alms- 
houses was  3,348,  of  whom  nearly  one-half  were  found 
in  a  single  institution,  the  City  of  St.  Louis  Poorhouse. 
The  usual  preponderance  of  males,  due  undoubtedly  to 
the  fact  that  dependent  women  are  less  likely  to  be  sent 
to  the  poorhouse  than  dependent  men,  is  exhibited  in 
the  Missouri  almshouse  population,  over  54  per  cent,  or 
1819,  being  males,  and  a  little  less  than -46  per  cent.,  or 
1529,  being  females.  As  regards  race,  3056  of  the  in- 
mates are  white,  while  292  are  colored.  This  makes  the 
proportion  of  almshouse  inmates  who  are  colored  a  lit- 
tle less  than  nine  per  cent,  while  the  colored  element  in 
the  total  population  of  the  State  constitutes  but  a  little 
over  five  per  cent.  Classified  as  regards  age,  1262,  or 
37.7  per  cent,  of  Missouri 's  almshouse  inmates  are  above 
sixty  years  of  age;  1932,  or  57.7  per  cent,  are  be- 
tween eighteen  and  sixty  years ;  and  154,  or  4.6  per  cent, 
are  under  eighteen.  It  is  evident  from  these  figures 
that  in  Missouri  as  elsewhere  an  undue  proportion  of 
the  aged  end  their  days  in  the  poorhouse.  While  per- 
sons above  sixty  years  of  age  constitute  but  a  little  over 
six  per  cent,  of  the  population  of  the  entire  country,  they 
form  over  thirty-seven  per  cent,  of  the  population  of 
Missouri's  almshouses.  The  proportion  of  children  and 
young  persons  in  Missouri's  almshouses  is  not  great, 
although  it  is  much  higher  than  it  should  be.  Of  the 
154  inmates  under  eighteen  years  of  age,  ninety-two  are 
between  two  and  fourteen  years. 

If  classified  according  to  physical  condition,  it  is 
evident  that  very  few  of  the  inmates  of  Missouri 's  alms- 
houses are  able-bodied.  Five  hundred  and  nine,  or  fif- 
teen per  cent,  were  reported  as  able  to  do  some  work, 
but  probably  not  more  than  one-third  of  these  might  be 
considered  in  any  proper  sense  able-bodied.  One  thous- 
and nine  hundred  and  nine  of  the  inmates,  or  fifty-seven 
per  cent.,  are  mental  defectives,  being  either  insane, 
feeble-minded,  or  epileptic.    Four  hundred  and  seventy- 

8 


^ve  more  are  reported  as  blind,  crippled,  or  paralytic. 
Bearing  in  mind  the  large  proportion  of  the  aged  among 
the  inmates,  it  seems  reasonable  to  conclude  that  Mis- 
souri 's  poorhouses  are  not  to  any  extent  places  of  re-  f 
sort  for  able-bodied  persons  who  are  too  lazy  or  shift- » 
less  to  support  themselves. 

The  Condition  of  the  Insane,  There  are  1177  in- 
sane persons  in  Missouri's  poorhouses;  and  of  this 
number  three-fourths,  or  884,  are  in  the  St.  Louis  City 
Poorhouse.  All  but  thirty-two  of  the  ninety  almshouses 
reporting  have  insane  inmates.  The  largest  number 
of  these  insane  are  not  found  in  the  poorer  counties 
which  have  poorly  equipped  almshouses,  but  in  the 
prosperous  counties  which  have  large  and  relatively 
costly  institutions.  There  seems  to  be  a  movement  in 
the  State  toward  increased  almshouse  care  of  the  indi- 
gent insane.  Indeed,  the  most  effective  argument  for 
building  a  new  poorhouse  often  seems  to  be  that  the 
county  may  ^*care  for  ks  insane  at  home,''  and  thus 
save  the  expense  of  treatment  at  a  State  hospital. 
Hence  it  comes  about  that  many  of  the  counties  with 
good  almshouses  have  turned  their  institutions  to  a 
great  extent  into  local  insane  asylums.  The  following 
item  which  went  the  rounds  of  the  press  of  the  State  in 
the  summer  of  1903  illustrates  the  tendency  spoken  of : 

"The  Ray  county  court,  at  its  June  session,  made  an  order  that 
all  of  its  insane  patients  should  be  removed  July  1st  from  the  asylum 
at  St.  Joseph  to  the  Ray  county  poor  farm.  The  court  figures  that 
the  amount  paid  the  asylum  for  keeping  of  the  patients  will  more 
than  provide  for  them  at  their  county  farm." 

That  this  movement  is  a  mistake  no  one  at  all  ac- 
quainted with  the  history  of  almshouse  care  of  the  in- 
sane can  doubt.  The  inevitable  result  of  such  care 
everywhere  is  various  degrees  of  inadequate  and  brutal 
treatment  ranging  downward  to  the  sheerest  cruelty. 
That  this  is  the  result  of  almshouse  care  of  the  indigent 


insane  in  Missouri,  there  is  abundant  evidence  to  show. 
However,  in  this  bulletin  we  shall  confine  ourselves  to 
the  evidence  furnished  by  student  investigators  or  by 
the  almshouse  superintendents  themselves.  In  the  first 
place,  we  have  to  note  that  fifty-four  out  of  the  ninety 
almshouses  reporting  have  cells  for  the  incarceration 
of  the  violent  insane.  Some  even  have  a  cell-house 
which  they  go  so  far  as  to  call  a  **jail.''  Again,  the 
question  was  asked  whether  any  sort  of  mechanical  re- 
straint was  used  to  control  the  insane.  Of  the  forty- 
eight  who  answered  this  question,  thirty-seven  admitted 
that  mechanical  restraint  was  used.  That  is,  seventy- 
five  per  cent,  of  the  almshouses  which  have  insane  in- 
mates use  mechanical  restraint  of  some  sort.  And  yet 
it  is  supposed  by  some  that  the  insane  in  our  almshouses 
are  never  violent!  Of  course,  mechanical  restraint 
employed  by  a  skilled  physician  may  be  sometimes  of 
great  benefit  to  the  insane ;  but  who  would  argue  that  it 
would  be  so  when  used  by  an  average  almshouse  of- 
ficial? 

A  third  line  of  evidence  as  to  the  condition  of  the 
insane  in  Missouri's  almshouses  may  be  furnished  by 
certain  quotations  taken  from  the  reports  of  investiga- 
tors and  even  of  the  superintendents  themselves.  Thus 
one  superintendent  says :  ' '  Sometimes  they  are  chained 
to  the  wall  till  they  are  quiet ;  if  too  bad  they  are  kept 
in  a  room  and  locked  up.''  An  investigator  says: 
''When  the  insane  are  violent,  they  are  put  in  cells, 
handcuffed,  and  tied  with  ropes."  Another  investiga- 
tor reports :  ' '  One  female  has  to  be  tied  by  block  and 
chain. ' '  Still  another  reports :  ' '  The  insane  are  locked 
in  cells  and  at  times  have  been  manacled.  Their  condi- 
tion is  too  filthy  for  adequate  description.  They  are 
locked  in  small  cells,  a  stool  in  each  cell,  excrement  cov- 
ers all  about  the  stool,  building  filthy,  persons  unclean ; 
enough  to  drive  a  sane  man  mad. ' '  Finally,  in  line  with 
the  above  the  following  may  be  quoted  from  the  report 

10 


of  the  Greene  county  grand  jury  on  the  condition  of 
the  insane  in  the  Greene  county  almshouse  (December, 
1903) : 

"We  found  twenty-three  insane  persons  confined  in  cells,  of 
which  there  are  at  least  three,  two  men  and  one  woman,  violently 
insane,  that  should  be  consigned  to  and  kept  in  the  asylum,  as  their 
condition  here  requires  them  to  be  kept  in  dark  blind  cells,  and  their 
constant  and  continual  ravings,  day  and  night,  are  a  constant  irri- 
tation to  the  other  inmates,  preventing  them  from  getting  the  sleep 
so  necessary  to  people  in  their  condition." 

Of  course,  the  almshouse  superintendents  are  not  to 
be  blamed  for  the  condition  of  the  insane  in  the  alms- 
houses. They  have  to  manage  as  best  they  can  the  per- 
sons who  are  turned  over  to  them  by  the  county  authori- 
ties ;  and  usually  they  are  conscientious  in  the  perform- 
ance of  their  duties.  The  blame  ultimately  rests  with 
the  people  of  the  whole  State  who  permit  by  law  the 
commitment  of  the  indigent  insane  to  almshouses;  and 
the  only  remedy  is  legislation  prohibiting  such  commit- 
ments and  providing  for  the  gradual  enlargement  of 
our  State  Hospital  facilities,  so  that  in  time  all  insane 
may  be  cared  for  in  State  institutions. 

The  Condition  of  Other  Defectives.  In  addition 
to  the  insane  there  are  551  feeble-minded  persons  and 
181  epileptics  in  the  almshouses  of  Missouri.  These 
numbers  probably  understate  rather  than  overstate  the 
proportion  of  the  almshouse  population  which  belongs 
to  these  classes,  as  many  cases  of  feeble-mindedness 
would  not  be  recognized  except  by  experts.  From  ten 
to  fifteen  per  cent,  of  the  feeble-minded  are  helpless 
idiots.  The  condition  of  these,  of  course,  is  equally  as 
bad  as  the  condition  of  the  insane.  As  for  the  higher 
grades  of  the  feeble-minded  it  may  not  be  so  evident 
that  their  presence  in  the  almshouses  is  to  be  condemned. 
But  from  the  social  point  of  view  they  need,  equally 
with  the  insane,  separate  treatment  in  special  institu- 

11 


tions.  Their  presence  in  the  almshouses  is  a  menace  to 
society  because  their  alBfiiction  is  hereditary.  The  in- 
vestigation revealed  at  least  two  instances  in  which  fee- 
ble-minded women  had  become  mothers  of  illegitimate 
children  while  inmates  of  almshouses. 

As  for  the  epileptics,  it  need  only  be  said  that  their 
presence  in  the  almshouses  is  a  hardship  to  them  and  to 
the  other  inmates.  The  almshouse  surroundings  are 
such  as  to  aggravate  their  disease  and  to  preclude  all 
possibility  of  their  cure ;  again,  they  are  often  danger- 
ous and  their  presence  is  necessarily  unpleasant  to  other 
inmates.  The  epileptics  in  our  almshouses  should 
therefore,  be  sent  to  a  State  hospital  or  colony  especially 
provided  for  them. 

There  are  in  addition  to  these  mental  defectives  a 
large  number  of  physical  defectives  in  our  almshouses. 
The  reports  show  263  cripples,  114  blind  persons,  and 
98  paralytics.  Under  the  existing  differentiation  of  our 
chairitable  institutions  these  persons  are  where  they  be- 
long. But  if  the  almshouse  is  to  be  made  a  comfortable 
home  for  these  infirm  classes  and  for  the  aged  worthy 
poor,  it  must  be  freed  from  the  classes  which  it  can  not 
properly  care  for.  Furthermore,  it  must  have  special 
provisions  for  the  care  of  the  sick  and  the  infirm  both 
in  its  construction  and  management.  Only  two  alms- 
houses in  the  State  have  nurses  for  the  care  of  the  sick 
(Jackson  county  and  St.  Louis  city),  and  these  are  not 
trained  nurses.  The  superintendent's  wife  is  usually 
matron,  and  is  supposed  to  look  after  the  sick;  but  on 
account  of  her  other  duties  she  can  do  little  or  no  nurs- 
ing. Practically,  then,  the  only  nursing  which  is  done 
in  our  almshouses,  both  in  the  urban  and  in  the  rural 
counties,  is  that  which  is  done  by  the  paupers  them- 
selves. 

The  Condition  of  Children.  Statistics  already 
quoted  show  that  there  are  154  persons  under  eighteen 

12 


years  of  age  in  the  almshouses  of  Missouri,  ninety-two 
of  these  being  between  the  ages  of  two  and  fourteen. 
The  chief  reason  why  there  are  not  more  children  in  Mis- 
souri's  poorhouses  is  that  the  Missouri  Children's 
Home  Society  is  extremely  active  in  taking  children 
from  the  poorhouses  and  placing  them  in  good  families. 
Probably  not  more  than  one-half  of  the  children  be- 
tween two  and  fourteen  years  which  remain  in  the  alms- 
houses of  the  State  are  healthy  children,  the  remaining 
half  being  feeble-minded,  epileptic,  physically  deformed 
or  diseased  children  who  can  not  be  placed  in  private 
families.  Again,  the  few  healthy  children  to  be  found 
in  the  almshouses  are  usually  there  in  company  with  one 
or  both  their  parents,  in  which  case  it  is  difficult  for  the 
Children's  Home  Society  to  get  possession  of  the  chil- 
dren. Df  course,  the  defective  children  should  be  sent 
to  the  special  institutions  which  exist  for  them,  the  fee- 
ble-minded and  the  epileptic  to  the  State  Colony  for  the 
Feeble-Minded  and  Epileptic  at  Marshall,  and  the  blind 
to  the  State  School  for  the  Blind  at  St.  Louis.  The 
county  authorities  should  understand  that  these  institu- 
tions exist  especially  for  the  care  of  defective  children 
of  these  classes ;  and  that  they  are  there  cared  for  and 
educated  at  the  expense  of  the  State  if  they  are  indi- 
gent. The  problem  of  disposing  of  the  deformed  and 
diseased  children  in  our  almshouses  is  not  so  easy,  see- 
ing that  there  exists  no  public  institution  especially  for 
them.  But  it  would  seem  that  the  county  authorities 
should  if  possible  commit  them  to  private  hospitals,  or 
else  send  them  to  the  hospital  of  the  medical  school  of 
the  University  of  Missouri,  for  treatment.  The  only 
effective  remedy  for  the  evil  of  allowing  children  to  re- 
main in  our  almshouses,  however,  is  legislation  which 
shall  prohibit  their  detention  in  almshouses  for  a  period 
longer  than  one  month. 

Buildings  and  Grounds,    Only  twelve  counties  in 

13 


Missouri  have  almshouse  buildings  costing  $10,000  or 
more,  viz.:  Boone,  Buchanan,  Clinton,  Cole,  Greene, 
Harrison,  Jackson,  Linn,  Macon,  St.  Charles,  Sullivan, 
and  St.  Louis  city.  Eleven  other  counties  report  build- 
ings costing  between  $5,000  and  $10,000.  In  all  the 
other  counties  reporting  the  almshouse  buildings  cost 
less  than  $5,000 ;  and  in  twenty-one  out  of  the  sixty  the 
cost  of  the  building  used  as  an  almshous^e  was  less  than 
$1,500.  In  other  words,  it  is  probable  that  at  least  one- 
third  of  the  county  almshouses  have  cost  to  build  them 
less  than  $1,500 ! 

The  ' '  cottage  plan ' '  of  construction  is  supposed  to 
be  the  best  for  almshouses.  There  is  only  one  alms- 
house in  Missouri  built  consistently  upon  this  plan,  and 
that  is  the  Pike  county  almshouse.  Unfortunately, 
however,  in  this  case  the  cottages  are  built  of  wood 
and  are  without  modem  improvements.  Pettis,  Daviess, 
and  one  or  two  other  counties  have  ahnshouses  ap- 
proaching this  type.  Fifteen  counties  have  alms- 
houses of  the  ^institutional"  type— one  or  more  large 
buildings  several  stories  in  height.  Practically  all  the 
other  almshouses  of  the  State  are  old  farmhouses  in 
different  stages  of  repair. 

The  actual  fitness  of  almshouse  buildings  for  their 
work  may  perhaps  better  be  judged  by  their  sanitary 
arrangements  than  in  any  other  way,  since  sanitary  ar- 
rangements are  so  important  in  dealing  with  the  infirm 
and  helpless  classes  found  in  the  almshouses.  Only  five 
almshouses  in  the  State  may  be  said  to  have  fully  mod- 
em arrangements  for  heating  lighting,  ventilation,  bath- 
ing facilities,  closets  and  sewerage,  viz. :  Buchanan, 
Jackson,  Macon,  Putnam  and  St.  Louis  city.  Seven 
other  counties  have  almshouses  with  nearly  or  partly 
modern  sanitary  arrangements;  viz.:  Boone,  Clinton, 
Greene,  Harrison,  Linn,  Livingston,  Pettis,  St.  Charles, 
and  Sullivan.  The  remaining  almshouses  of  the  State 
have  only  such  sanitary  arrangements  as  are  found  at 

14 


VES3ITY 

or 

an  ordinary  farmhouse.  Such  primitive  arrangements 
may,  of  course,  answer  very  well,  where  the  number  in 
the  almshouse  is  small,  not  larger  than  an  ordinary  fam- 
ily ;  but  it  is  manifest  that  where  a  large  number  of  sick 
and  infirm  people  are  brought  together  the  best  sanitary 
arrangements  are  needed. 

The  superintendents  of  the  almshouses  in  their  re- 
ports to  the  department  often  show  consciousness  of  the 
inadequacy  of  their  facilities.  One  writes:  **This 
county  has  very  poor  accommodations  for  its  inmates ; 
while  there  are  not  many  still  they  are  human.''  An- 
other writes:  ^^The  equipments  of  the  house  are  not 
what  they  should  be  *  *  *  not  convenient  for  keep- 
ing the  class  of  people  who  go  to  poor  farms.''  An- 
other says,  regarding  the  farm  connected  with  the  alms- 
house :  ^  ^  My  opinion  of  the  county  farm  iis  that  it  is  a 
poor  farm,  sure  enough. ' ' 

This  brings  us  to  a  consideration  of  the  amount 
of  land  which  should  be  associated  with  the  almshouse. 
The  prevalent  idea  in  Missouri  of  what  a  county  alms- 
house should  be  is  expressed  in  its  most  common  name, 
*' county  poor  farm."  The  idea  is,  not  only  that  a 
farm  should  be  associated  with  the  almshouse,  but  that 
the  institution  should  be  made  as  nearly  self-supporting 
as  possible  through  the  labor  of  the  paupers.  Hence, 
we  find  many  county  almshouses  with  large  farms  at- 
tached. Of  the  eighty-five  which  reported  the  amount 
of  their  land,  twenty-eight  had  over  160  acres,  forty-five 
had  between  fifty  and  160  acres,  and  twelve  had  under 
fifty  acres.  It  is.  doubtful  whether  a  large  amount  of 
land  should  be  associated  with  an  almshouse.  As  was 
shown  above,  only  a  few  of  the  poorhouse  inmates  are 
able-bodied :  therefore,  the  idea  that  the  institution  may 
be  rendered  self-supporting  through  the  labor  of  its  in- 
mates is  fallacious.  Again,  if  the  amount  of  land  is 
large  the  superintendent  has  to  spend  nearly  all  of  his 
time  in  managing  the  farm  to  the  neglect  of  the  inmates. 

15 


Further,  the  economy  of  a  large  farm  in  connection 
with  the  almshouse  is  now  questionable  on  account  of 
the  cheapness  with  which  supplies  may  be  purchased.  It 
has,  at  any  rate,  been  demonstrated  that  an  institution, 
with  a  small  amount  of  land  can  be  run  as  cheaply  as 
one  with  a  much  larger  amount.  Finally,  the  weightiest 
argument  against  the  large  farm  in  connection  with  the 
almshouse  is  that  it  usually  necessitates  locating  the 
almshouse  far  in  the  country  where  it  and  its  inmates 
can  be  but  seldom  visited.  A  small  farm  near  the 
county  seat  is,  therefore,  preferable  to  a  large  one  sev- 
eral miles  in  the  country.  Probably  the  proper  size  of 
farm  for  an  average  Missouri  almshouse  would  be  about 
fifty  acres,  though,  of  course,  the  size  should  vary  ac- 
cording to  the  number  of  inmates  and  other  circum- 
stances. In  any  case  it  should  be  large  enough  to  fur- 
nish labor  for  all  able-bodied  inmates  and  to  supply  the 
acreage  needed  for  gardening  and  grounds. 

Management,  The  most  striking,  and  at  the  same 
time  the  most  regrettable,  feature  of  almshouse  manage- 
ment in  Missouri  is  that  most  of  the  almshouses  are 
managed  by  what  may  be  called  the  '4ease  system.^' 
That  is,  the  management  of  the  almshouse  is  let  out  to 
the  lowest  bidder,  or,  as  it  is  usually  reported,  **to  the 
lowest  and  best  bidder.  ^ '  If  the  county  court,  which  in 
Missouri  is  the  legal  board  of  managers  of  all  county 
institutions,  does  not  openly  advertise  for  bids,  it  never- 
theless usually  lets  out  the  care  of  the  almshouse  and 
its  inmates  at  so  much  per  inmate  per  week.  Only  in 
thirty-five  counties  of  the  State  is  the  almshouse  super- 
intendent paid  a  fixed  salary.  In  the  remaining  coun- 
ties the  lease  system,  under  one  form  or  another,  pre- 
vails. 

This  *4ease  system,'^  making,  as  it  does,  the  wages 
of  the  superintendent  dependent  upon  what  he  can  save 
from  the  inmates,  is  doubtless  responsible  for  many  of 

16 


the  worst  conditions  in  our  almshouses.  Many  of  the 
superintendents  working  under  it  express  their  disap- 
proval of  it.  Thus  one  writes:  *^The  plan  used  in 
this  county  does  not  meet  my  approval. ' '  Another  can- 
didly details  the  workings  of  the  system  as  follows :  *  *  A 
few  years  ago  the  poor  were  let  at  $38.00  per  head  per 
year.  Under  that  treatment  there  were  nine  out  of  nine- 
teen that  died,  and  the  county  had  to  pay  doctor's  bill 
and  burial  expenses  which  cost  more  than  board  and 
clothes.  They  now  pay  $72.00  a  head  per  year,  and  see 
that  it  is  cheaper  and  more  humane. ' '  This  is  truly  a 
record  of  progress  under  the  ** lease  system; ''  we  wish 
that  we  could  record  that  that  particular  county  had 
progressed  so  far  as  to  pay  its  superintendent  a  fixed 
salary. 

As  regards  the  relative  cheapness  of  the  two  sys- 
tems, there  can  be  no  doubt  that  the  poor  can  be  cared 
for  quite  as  cheaply  with  humane  and  modern  methods 
under  officials  at  fixed  salaries  as  under  the  lease  sys- 
tem. There  are  many  counties  paying  as  high  as  two 
dollars  per  week  for  each  pauper  under  the  lease  system 
and  getting  poor  service ;  while  there  are  other  counties 
which  have  modern  buildings  and  pay  their  superin- 
tendents fixed  salaries,  and  yet  support  their  poor  in 
comfort  at  a  less  total  expenditure  per  capita.  The  ex- 
perience of  a  single  Missouri  county  will  serve  to  illus- 
trate this.  Clinton  county,  which  has  now  one  of  the 
best  almshouses  in  the  State,  formerly  cared  for  its  pau- 
pers under  the  lease  system.  The  superintendent  writes 
as  follows:  *^It  has  proven  more  satisfactory  to  hire 
the  superintendent  by  the  year  than  to  let  the  inmates 
out  to  the  lowest  bidder.  This  county  has  tried  both 
ways  and  the  county  court  found  it  most  satisfactory 
to  hire  the  superintendent  and  furnish  the  supplies. 
The  net  expense  for  each  inmate  last  year  was  $1.48  per 
week;  before  they  changed  from  boarding  them  out  it 


17 


was  about  $2.00  per  week.  So  it  is  cheaper  in  this 
county  than  letting  them  to  the  lowest  bidder.'' 

Nobody  claims  that  the  lease  system  is  humane; 
if  it  is  not  cheaper,  the  only  argument  in  its  defense 
falls.  There  is  no  reason,  then,  why  there  should  not 
be  at  once  mandatory  legislation  prohibiting  this  form 
of  caring  for  the  poor  in  Missouri ;  and  this  is  an  indis- 
pensable step  in  the  reform  of  our  almshouse  system. 

Of  the  thirty-five  counties  which  pay  their  superin- 
tendents fixed  salaries  only  eight  pay  salaries  higher 
than  $600,  and  four  out  of  these  are  urban  counties; 
twenty  counties  pay  their  superintendent  salaries  vary- 
ing from  $400  to  $600  inclusive ;  five  counties  pay  under 
$400:  and  two  do  not  report  the  amount.  From  this 
it  would  seem  probable  that  the  average  Missouri 
county  would  find  no  trouble  in  procuring  a  good  man  to 
manage  its  almshouse  for  a  salary  of  $600  a  year  in  ad- 
dition to  the  keeping  of  his  family. 

The  average  annual  expense  of  eighty-one  alms- 
houses situated  in  rural  counties  is  a  trifle  over  $1,600 
each.  The  total  cost  of  the  ninety  almshouses  not  sit- 
uated in  the  counties  which  contain  our  three  large  cities 
is  about  $145,000  per  annum.  The  aggregate  cost  of  the 
Jackson  county,  Buchanan  county  and  St.  Louis  city 
almshouses  per  annum  is  about  $180,000.  Thus  the  to- 
tal cost  of  the  almshouse  system  to  the  taxpayers  of  the 
State  is  over  $300,000  a  year.  The  financial  manage- 
ment of  each  almshouse  is  perhaps  best  indicated  by  the 
average  cost  per  inmate  per  week.  In  this  matter  there 
is  great  variation  between  Missouri  almshouses,  the  low- 
est cost  per  inmate  per  week  reported  being  ninety  cents, 
the  highest  $2.90.  However,  in  the  majority  of  the  alms- 
houses the  cost  of  supporting  each  inmate  per  week  lies 
between  these  two  extremes.  In  forty-six  out  of  sev- 
enty-five almshouses  reporting  the  average  cost  of  car- 
ing for  each  inmate  a  week  ranges  from  $1.50  to  $2.00 


18 


inclusive.  In  twenty-three  of  the  almshouses,  it  was  un- 
der $1.50  and  only  in  six  was  it  over  $2.00  per  week. 

One  of  the  most  important  matters  in  the  manage- 
ment of  an  almshouse  is  the  proper  classification  of  the 
inmates.  By  this  is  meant  the  entire  separation  of  cer- 
tain classes  of  inmates  from  other  classes,  communica- 
tion and  association  being  allowed  only  under  certain 
circumstances  with  the  consent  of  the  superintendent. 
Such  classification  and  separation  is  universally  recog- 
nized by  experts  as  the  essential  basis  of  successful 
almshouse  administration.  The  most  fundamental  of 
these  classifications  is  that  of  sex.  The  two  sexes  should 
of  course  be  absolutely  separated  from  each  other  in 
the  almshouse,  save  only  in  the  case  of  aged  married 
couples.  A  scarcely  less  fundamental  classification  is 
that  of  race.  Still  other  classifications  should  be  made 
according  to  the  age,  health,  character,  and  condition 
of  the  inmates. 

It  is  too  much  to  say  that  classification  does  not  ex- 
ist in  the  majority  of  Missouri's  almshouses;  but  in  all 
save  a  few  it  is  very  imperfectly  developed.  In  four- 
teen of  the  ninety  reporting,  there  is  no  classification  at 
all— not  even  separation  of  the  sexes.  In  the  remaining 
there  is  separation  of  the  sexes,  but  in  many  instances 
it  is  to  be  feared  that  this  separation  is  not  very  strict. 
In  fifty  out  of  these  seventy-six  almshouses  separation 
of  the  sexes  is  the  only  classification  attempted.  Twenty 
separate  both  sexes  and  races.  Twenty-eight  counties 
have  separate  buildings  for  colored  inmates,  a  few  coun- 
ties having  these  which  have  at  present  no  colored  per- 
sons in  their  almshouses.  Of  the  sixty-two  counties 
which  do  not  make  separate  provision  for  the  colored 
people  thirty-four  have  no  colored  inmates,  and  of  the 
twenty-eight  which  have  colored  inmates,  but  do  not 
make  separate  provision,  seventeen  have  less  than  three 
colored  inmates.  Three  almshouses  report  a  classifica- 
tion according  to   sex  and  condition.    Finally,   three 

19  / 


almshouses  report  a  classification  according  to  sex,  race, 
age,  and  character.  These  three  are  the  almshouses  of 
Jackson,  Clinton,  and  Macon  counties,  which  alone  of  all 
the  county  almshouses  of  the  State  may  be  said  to  have 
an  adequate  classification. 

Another  very  important  matter  in  the  management 
of  an  almshouse  is  the  enforcement  of  the  *^work  test;" 
that  is,  the  compelling  of  the  able-bodied  inmates  to 
work.  If  the  almshouse  is  to  be  made  a  comfortable 
home  for  the  aged  and  infirm  poor,  in  order  that  it  may 
not  be  an  attractive  place  for  the  lazy  and  shiftless  able- 
bodied,  there  should  be  a  vigorous  compulsion  to  work. 
In  other  words,  work  should  be  required  of  all  able- 
bodied  inmates.  It  is  disappointing,  therefore,  to  find 
that  only  in  a  few  Missouri  almshouses  is  there  a  work- 
test  in  force.  In  sixteen  only  of  the  ninety  reporting  is 
labor  required;  the  remaining  seventy-four  report  that 
it  is  optional. 

The  regulations  regarding  admission  and  discharge 
of  inmates  are  also  important  in  the  management  of  an 
almshouse.  In  nearly  all  counties  the  county  court  or 
some  member  thereof  has  officially  to  decide  upon  the 
admission  of  an  inmate,  but  in  some  counties  the  super- 
intendent of  the  ateshouse  also  has  power  to  admit  in- 
mates provisionally  at  least.  In  only  three  or  four  coun- 
ties do  there  appear  to  be  definite  regulations  as  to  what 
entitles  a  person  to  receive  relief  in  the  almshouse. 
These  counties  require  complete  destitution  on  the  part 
of  the  applicant,  and  inability  of  either  children  or  par- 
ents, if  any,  to  provide  support.  It  is  needless  to  say 
that  these  regulations  should  be  enforced  in  every 
county,  and  in  addition  there  should  be  some  investiga- 
tion to  ascertain  whether  the  facts  are  as  alleged.  The 
rules  regarding  the  discharge  of  inmates  seem  to  be 
even  more  lax  than  those  regarding  the  admission  of 
inmates.    In  most  instances  the  inmate  is  allowed  to 


20 


discharge  himself  without  notice,  provided  of  course 
that  he  is  not  detained  as  insane. 

Finally,  a  matter  which  should  be  considered  cer- 
tainly of  some  importance  in  almshouse  management  is 
what  is  done  to  brighten  and  cheer  the  lives  of  the  in- 
mates. Even  in  our  large  city  almshouses  it  is  to  be 
feared  that  not  much  is  done  in  this  way.  Only  a  single 
almshouse  in  Missouri,  for  instance,  has  a  library,  and 
that  is  Jackson  county  almshouse,  a  library  for  which 
was  provided  by  a  few  philanthropic  women  of  Kansas 
City.  Nearly  all  the  almshouses  report  that  newspapers 
are  taken,  but  the  extent  to  which  they  are  taken  is  not 
known.  Amusements  and  recreation  for  the  inmates 
seem  almost  entirely  lacking;  and  even  work  is  not 
systematically  provided  for  all  who  wish  to  work  to  pass 
away  the  time.  Of  the  ninety  almshouses  reporting, 
fifty-five  have  no  religious  services  whatsoever,  twenty- 
five  have  only  occasional  religious  services,  and  only 
ten  have  regular  services,  six  of  these,  however,  being 
monthly. 

Model  Almshouses,  Strictly  speaking,  the  model 
almshouse  still  remains  to  be  built  in  Missouri.  How- 
ever, several  counties  have  almshouses  so  good  that 
they  may  well  be  pointed  out  as  models  for  other  coun- 
ties to  imitate.  Only  almshouses  in  rural  counties  are 
here  considered.  Probably  the  best  almshouse  in  a  ru- 
ral county  in  the  State  is  the  Macon  county  almshouse. 
Not  only  is  its  cost  greater  than  any  other  ($25,000), 
but  it  seems  best  adapted  to  its  work.  The  second  best 
almshouse  in  the  State  in  a  rural  county  is  probably  that 
of  Clinton  county.  Boone  county  has  also  a  good  build- 
ing, though  in  some  ways  it  is  not  well  adapted  to  its 
purpose  and  its  sanitation  is  poor.  Among  other  coun- 
ties which  have  almshouses  that  might  to  some  extent  be 
considered  as  models  are  Cole,  Harrison,  Putnam,  and 
Sullivan. 

21 


Progress  During  1903.  Some  commendable  signs 
of  progress  have  been  shown  as  regards  almshouse  con- 
ditions during  the  past  year.  A  number  of  counties 
have  agitated  the  matter  of  erecting  new  almshouses. 
This  has  resulted  successfully  in  at  least  two  counties. 
Johnson  county  has  decided  to  build  a  model  almshouse 
in  all  respects,  which  it  will  call  a  * '  County  Home, ' '  a 
name  which  certainly  deserves  to  be  largely  copied.  St. 
Francois  county  has  also  resolved  to  erect  a  new  $8,000 
building.  At  least  two  counties  have  changed  from  the 
^^ease  system"  to  paying  the  superintendent  a  fixed  sal- 
ary. The  greatest  step  in  advance,  however,  has  been 
the  appointment  of  county  Boards  of  Visitors  in  several 
counties  according  to  the  terms  of  the  Act  of  1903,  which 
makes  it  obligatory  for  the  circuit  judge  to  appoint  such 
a  board  for  any  county  whenever  fifteen  reputable  citi- 
zens of  the  county  shall  petition  that  such  a  board  be  ap- 
pointed. The  duties  of  such  a  board  are  to  visit  and  in- 
spect the  county 's  charitable  and  correctional  institu- 
tions and  report  their  condition  quarterly  to  the  State 
Board  of  Charities,  the  county  court  and  the  circuit 
judge.  Such  boards  of  visitors  have  already  been  ap- 
pointed in  the  following  counties:  Andrew,  Barton, 
Benton,  Boone,  Butler,  Daviess,  DeKalb,  Dunklin,  Cal- 
laway, Clay,  Clinton,  Gentry,  Harrison,  Jasper,  Linn, 
Livingston,  Jefferson,  Platte,  Mercer,  Nodaway, 
Grundy,  Putnam,  Eipley,  St.  Clair,  St.  Francois,  St. 
Louis,  Stoddard  and  Washington.  These  boards  have 
already  accomplished  much  good  in  the  short  time  that 
they  have  been  in  existence,  and  they  promise  to  do 
much  more  wherever  created.  For  example,  the  Board 
of  Visitors  in  St.  Francois  county  secured  the  abolition 
of  the  *^ lease-system''  and  the  decision  to  erect  a  new 
almshouse.  It  is  to  be  hoped  that  the  next  legislature 
will  make  the  law  mandatory  and  thereby  secure  the 
appointment  of  such  boards  in  all  the  counties  of  the 
State. 

22 


IL 

A  Bbief  Summary  of  the  Principles  Which  Should 
Govern  Almshouse  Administration. 

It  is  universally  recognized  by  those  who  have 
studied  almshouse  administration  that  the  almshouse  is 
not  fitted  to  care  for  those  classes  of  dependents  who 
require  special  or  scientific  treatment.  By  its  very 
nature  the  almshouse  is  a  small  local  institution  which 
cannot  be  expected  to  have  at  its  head  an  official  with 
professional  training  and  experience.  Therefore,  cer- 
tain classes  who  need  special  care  involving  special 
knowledge  should  hot  be  committed  to  the  almshouse. 
These  classes  include  children,  delinquents,  the  insane, 
the  epileptic,  the  feeble-minded,  the  blind,  and  the  deaf- 
mutes.  Let  us  consider  in  the  order  given  the  reasons 
why  these  classes  should  be  excluded  from  the  alms- 
houses. 

1.  Children  above  the  age  of  babyhood  should 
never  be  committed  to  an  almshouse  because  the  child 
through  its  imitative  nature  readily  takes  on  the  taint 
of  pauper  surroundings  which  cling  to  it  through  life; 
and  because  the  education  of  no  child  can  be  properly 
conducted  in  an  almshouse. 

2.  Tramps  and  disorderly  persons  should  never 
be  committed  to  an  almshouse,  as  the  almshouse  is  not 
a  correctional  institution  and  cannot  properly  deal  with 
delinquent  persons,  while  their  mere  presence  in  the  in- 
stitution brings  it  into  such  ill  repute  that  the  self- 
respecting  poor  shun  it  even  in  the  direst  extremities. 

3.  Perhaps  the  presence  of  no  other  class  in  the 
almshouse  gives  rise  to  such  grave  abuses  as  the  pres- 
ence of  the  insane.  Because  the  insane  need  the  medical 
care  of  specialists,  skilled  attendants,  cheerful  sur- 
roundings, and  a  scientific  diet,  all  of  which  are  lacking 
in  an  almshouse,  their  condition  often  becomes  very 

23 


pitiable.  This  neglect  easily  shades  off  into  the  brutal- 
ity of  leaving  the  insane  dirty  and  half -naked,  confined 
in  steel  or  wooden  cells.  Insane  persons  should,  there- 
fore, never  be  committed  to  the  almshouse,  and  those 
who  become  insane  after  commitment  should  be  speedily 
removed. 

4.  Epileptics  should  not  be  committed  to  an  alms- 
house, because  like  the  insane  they  need  special  medical 
care  and  treatment,  through  which  their  condition  is 
always  improved  and  permanent  recovery  sometimes 
effected.  As  all  epileptics  become  insane  if  their  dis- 
ease is  neglected,  the  same  objections  to  almshouse  care 
are  applicable  in  their  case  as  in  the  case  of  the  insane. 

5.  Feeble-minded  persons  should  not  be  kept  in 
almshouses,  because  their  presence  there  is  both  a  hard- 
ship to  the  other  inmates  and  a  danger  to  the  com- 
munity. No  almshouse  is  properly  equipped  to  care 
for  and  restrain  idiotic  and  feeble-minded  persons, 
while  the  loose  rules  of  admission  and  discharge  allow 
such  persons  to  go  and  come  as  they  please,  which  is  a 
danger  to  the  community.  This  is  especially  a  danger 
in  the  case  of  feeble-minded  women  who,  under  such  lax 
care,  almost  invariably  become  mothers,  and  so  trans- 
mit their  defect  to  succeeding  generations.  Feeble- 
minded children  should,  of  course,  be  put  into  special 
institutions  where,  through  training,  they  may  be  often 
much  improved. 

6.  The  desirability  of  removing  blind  and  deaf- 
mute  children  from  the  almshouses  to  special  institu- 
tions for  their  instruction  was  early  recognized ;  but  the 
desirability  of  special  institutions  for  dependent  adults 
of  these  classes  is  also  now  admitted.  Certainly  the 
legislation  for  removing  blind  and  deaf-mute  children 
from  our  almshouses  should  be  enforced. 

By  the  exclusion  of  all  classes  from  the  almshouse, 
which  require  special  scientific  treatment,  the  true  func- 
tion of  the  almshouse  discloses  itself.     Manifestly  the 

24 


class  which  remains  for  almshouse  care  is  the  aged  and 
infirm  poor.  In  every  old-settled  community  this  class, 
which  requires  no  scientific  treatment,  is  sufficiently 
large,  and  it  should  be  the  function  of  the  almshouse  to 
provide  a  home  for  them. 

Even  after  classifying  so  many  classes  of  depend- 
ents out  of  the  almshouse  we  still  will  not  have  a  prop- 
erly administered  institution  unless  there  is  classifica- 
tion ivithin  the  almshouse.  It  is  generally  recognized 
that  a  good  almshouse  should  classify  its  inmates  in  at 
least  four  different  ways.  The  first  and  most  im- 
portant classification  is  in  regard  to  sex.  The  sexes 
should  be  absolutely  separated  from  each  other,  and  if 
possible  housed  in  different  buildings,  if  the  institution 
is  to  be  kept  free  from  scandal.  A  second  classifica- 
tion, which  should  not  be  neglected,  is  in  regard  to  color. 
Fully  carried  out  this  would  result  in  duplicate  institu- 
tions, one  for  whites  and  one  for  colored.  At  the  least, 
it  would  mean  a  separate  building  for  the  colored  if  they 
numbered  more  than  three  or  four.  A  third  necessary 
classification  is  in  regard  to  health.  This  means  that 
there  should  be  special  provision  for  the  sick,  and  isola- 
tion of  those  who  have  contagious  diseases,  such  as  con- 
sumption. The  fourth  classification  which  should  be 
made  is  in  regard  to  mental  and  moral  condition.  This 
means  that  persons  who  are  congenial  should  be 
grouped  together  and  that  some  persons  should  be  given 
a  room  alone. 

Even  in  an  ideal  almshouse  at  least  this  much  class- 
ification is  necessary.  But  in  case  the  classes  above 
spoken  of  have  not  been  removed  from  the  almshouse 
much  further  classification  is  required.  There  should 
then  be  isolation  of  the  mentally  defective  and  special 
provision  to  keep  the  children  from  being  contaminated 
by  the  other  inmates. 

The  question  of  classifying  properly  the  inmates  of 
the  almshouse  brings  us  to  the  question  of  the  proper 

25 


constniction  of  the  almshouse.  It  is  now  generally 
agreed  that  the  cottage  plan  of  construction  is  best. 
There  are  many  disadvantages  to  a  single  large  bnild- 
ing,  not  the  least  of  which  is  that  it  does  not  make  easy 
proper  classification  and  separation  of  the  inmates.  For 
an  average  Missouri  county  the  almshouse  should  con- 
sist of  three  cottages,  one  for  the  female  inmates,  one 
for  the  males,  and  one  for  the  superintendent's  family. 
The  cottages  for  the  inmates  should  be  built  to  accom- 
modate from  ten  to  twenty-five  persons,  and  should 
have  both  dormitories  and  single  rooms  to  allow  for 
proper  classification  of  the  inmates.  The  cottage  for 
the  superintendent's  family  would,  of  course,  be  smaller. 
If  needed,  a  fourth  cottage  for  the  colored  inmates 
should  be  added.  The  whole  institution  should  be 
equipped  with  the  best  modern  sanitary  arrangements 
and  should  preferably  be  heated  by  a  central  plant.  The 
average  cost  of  such  an  institution,  if  built  of  brick, 
would  not  be  above  $15,000. 

Of  course,  the  care  of  the  almshouse  and  its  inmates 
should  not  be  let  out  to  the  lowest  bidder,  as  is  done  in 
about  two-thirds  of  the  counties  of  our  State.  This 
*  ^farming  out''  of  the  poor,  as  it  is  called,  gives  rise 
to  serious  abuses  wherever  practiced.  The  proper 
method  is  to  hire  a  competent  man  as  superintendent 
at  a  fixed  salary,  and  then  furnish  supplies  as  needed 
for  the  institution  by  requisitions  on  the  county  au- 
thorities. 

As  to  management,  the  most  important  matter, 
after  those  already  mentioned,  is  in  regard  to  the  ad- 
mission and  discharge  of  inmates.  The  *^ work-test" 
should  be  rigidly  enforced ;  that  is,  no  able-bodied  per- 
sons should  be  admitted  without  being  required  to  work. 
Only  thus  can  idle  and  vicious  persons,  like  tramps,  be 
effectually  excluded.  Inmates  should,  also,  not  be  per- 
mitted to  discharge  themselves,  and  should  be  released 


26 


only  when  there  is  some  assurance  that  they  will  be 
properly  cared  for  outside  of  the  institution. 

A¥ork  should  be  furnished  for  all  able  and  willing 
to  work.  This  should  be  done,  not  so  much  for  economy, 
as  on  the  general  principle  that  the  normal  person  is 
happier  and  more  content  when  occupied  than  when  idle. 
As  noted  above,  in  the  case  of  the  able-bodied  work 
should  be  required,  not  optional.  Eecreation  and  amuse- 
ments should  not  be  wholly  neglected.  For  this  reason 
newspapers  and  books  ought  to  be  found  in  every  alms- 
house, and  simple  entertainments  should  be  occasion- 
ally provided  for  the  inmates.  Especially  ought  there 
to  be  regular  religious  services  of  some  sort,  if  possible, 
weekly. 

If  these  recommendations  can  be  carried  out,  the 
almshouse  under  a  humane  and  intelligent  superintend- 
ent may  yet  become  a  genuine  institution  of  philan- 
thropy, where  the  respectable  aged  and  infirm  poor 
may  find  a  home  such  as  enlightened  Christian  sym- 
pathy would  give  them. 

III. 

•Almshouse  Abuses  and  Their  Coreection. 

(Extracts  from  a  paper  read  by  Charles  A.  Ell  wood,  Professor  of  Sociology, 
University  of  Missouri,  at  the  National  Conference  of  Charities  and  Correction 
at  Atlanta,  Ga.,  1903.) 

To  the  practical  philanthropist,  who  has  not  nar- 
rowed his  interest  to  a  locality,  a  sect,  or  a  class,  there 
is  no  more  important  problem  than  that  of  the  correc- 
tion of  abuses  in  our  county  and  municipal  institutions, 
and  especially  abuses  in  the  management  of  our  county 
almshouses. 

The  conditions  in  Missouri  are  by  no  means  excep- 
tional. They  simply  illustrate  the  conditions  which 
obtain  in  many  States.    What  efforts,  then,  can  be  made 

27 


to  improve  these  conditions  and  correct  these  errors! 
First,  there  are  certain  abuses  in  the  management  of 
almshouses  which  maj^  be  corrected  through  the  visita- 
tion of  local  boards  of  visitors;  second,  there  are 
abuses  which  may  be  corrected  through  inspection  by 
State  officials;  third,  there  are  abuses  which  can  only 
be  corrected  through  mandatory  and  prohibitive  legisla- 
tion. That  frequent  and  persistent  visitation  of  the 
almshouse  by  local  committees  can  accomplish  much 
good  is  beyond  question.  It  is  an  efficient  means  of 
enlisting  the  interest  of  a  number  of  intelligent  citizens 
in  each  county  in  the  almshouse  problem,  and  so  fur- 
nishes the  basis  for  agitation  for  proper  legislation.  If 
their  visits  are  frequent  enough  (they  should  not  be  less 
often  than  once  a  month)  such  local  boards  can  easily 
bring  about  in  the  almshouse  humane  treatment  of  the 
inmates,  cleanliness  of  persons  and  premises,  better  care 
of  the  sick,  and  many  other  minor  reforms.  Further, 
they  can  aid  in  providing  reading  matter,  work,  recrea- 
tion, and  religious  services  for  the  inmates,  and  their 
interest  in  the  almshouse  will  always  be  indispensable 
for  insuring  the  best  possible  management. 

The  laws  of  New  York,  Ohio  and  other  States  i^ro- 
vide  for  such  local  boards  of  visitors ;  and  the  last  Gen- 
eral Assem.bly  of  Missouri  passed  a  law  providing  for 
such  county  boards  of  visitors,  from  which  many  good 
results  are  expected  to  flow.  But  in  States  which  have 
not  such  laws  this  work  of  visiting  the  almshouses  can 
be  inaugurated  in  any  county  by  a  few  philanthropic 
men  and  women. 

But  local  boards  of  visitors,  whether  authorized  by 
law  or  not,  because  the}'  are  local  and  made  up  of  ordi- 
nary citizens,  not  of  experts,  cannot  effect  such  reforms 
in  the  almshouses  of  a  State  as  the  inauguration  of  an 
adequate  system  of  classification,  the  erection  of  modern 
buildings  adapted  to  such  classification  and  the  exclu- 
sion of  classes  which  should  not  be  in  almshouses.    In 

28 


part,  such  reforms  may  be  brought  about  through  State 
inspection  and  supervision  by  the  State  Board  of  Chari- 
ties. I  do  not  mean  occasional  visits  by  members  of  the 
State  Board  of  Charities  (which  in  my  opinion  accom- 
plish little),  but  the  systematic  visitation  and  inspec- 
tion of  all  the  almshouses  in  the  State  at  least  once  each 
year  by  the  secretary  of  the  State  board  or  by  a  special 
inspector  working  under  him.  The  value  of  such  inves- 
tigation is  great. 

The  inspector,  being  the  representative  of  the  State 
and  at  the  same  time  an  expert,  is  in  a  position  to  sug- 
gest and  gradually  enforce  an  adequate  system  of  class- 
ification of  inmates  in  the  almshouse,  and  to  advise 
about  the  construction  of  new  almshouses.  He  would 
also  be  able  perhaps  to  influence  the  county  authorities 
to  appoint  better  men  as  superintendents,  to  make  more 
rigorous  rules  regarding  the  admission  and  discharge 
of  inmates,  and  to  require  work  of  all  able-bodied  in- 
mates. Finally,  he  might  exercise  considerable  influence 
in  securing  the  removal  from  the  almshouses  of  certain 
classes  of  inmates  who  should  be  cared  for  in  special 
institutions,  such  as  the  insane,  the  feeble-minded  and 
the  children. 

But  here  the  limitations  of  State  inspection  and 
supervision  without  the  support  of  mandatory  legisla- 
tion begin  to  become  manifest.  The  chief  value  of  in- 
spection then  is  that  it  is  a  step  toward  securing  definite 
legislation. 

Let  us  consider  a  few  of  the  abuses  which  require 
for  their  correction  such  legislation.  In  States  where 
the  cost  of  caring  for  the  indigent  insane  devolves  upon 
the  county,  ex]3erience  shows  that  it  is  impossible  to  get 
counties  to  send  all  of  their  insane  to  State  hospitals, 
since  the  support  of  an  indigent  insane  person  in  a 
State  hospital  costs  always  about  twice  as  much  as  in 
the  county  almshouse. 

Legislation  of  one  sort  or  another  is,  then,  neces- 

29 


sary  to  get  the  insane  out  of  the  almshouses.  Either  the 
State  must  declare  the  insane  to  be  State  wards,  taking 
upon  itself  the  burden  of  supporting  the  indigent  insane, 
or  it  must  prohibit  the  keeping  of  the  indigent  insane 
in  almshouses  and  make  obligatory  their  commitment 
to  State  hospitals.  The  case  with  the  feeble-minded  and 
epileptic  is  practically^  the  same.  Again,  inspection  and 
the  efforts  of  philanthropic  societies,  will- not  suffice  to 
keep  children,  either  defectives  or  normal,  out  of  alms- 
houses, but  definite  prohibitive  legislation  is  necessary. 
Finally,  it  is  idle  to  talk  of  improving  conditions  and 
correcting  errors  in  the  management  of  almshouses  by 
inspection  and  visitation  as  long  as  the  system  of  man- 
agement permitted  by  law  is  that  of  '  ^  farming  out ' '  the 
care  of  the  inmates  to  the  lowest  bidder  or  to  some  one 
who  has  a  political  pull.  Under  such  a  vicious  system, 
visitation  and  inspection  can  accomplish  little  except  as 
they  result  in  agitation  for  legislative  prohibition  of  the 
*^  farming  ouf  system. 

But  how  can  these  three  m.ethods  of  improving  con- 
ditions in  almshouses,  visitation,  inspection  and  legis- 
lative enactment,  be  put  practically  into  eifect  in  States 
where  none  of  these  exist?  The  answer  is,  the  order  of 
evolution  is  that  indicated.  First  must  come  the  visita- 
tion of  the  almshouses  by  self-appointed  local  com- 
mittees of  philanthropic  men  or  women.  If  a  State 
Board  of  Charities  exists,  the  agitation  can  best  be  car- 
ried on  through  that  body,  first  to  obtain  State  inspec- 
tion and  then  definite  legislation.  But  in  States  where 
no  State  Board  exists,  philanthropic  workers  need  not 
be  discouraged.  A  general  educational  campaign  can 
be  carried  on,  visitation  can  be  spread  from  county  to 
county,  and  even  State  inspection  can  be  undertaken  by 
a  voluntary  State  organization,  such  as  a  *  *  State  Chari- 
ties Aid  Association,''  though  above  all  efforts  should 
be  concentrated  on  the  securing  of  a  State  Board  of 
Charities  of  the  supervisory  type.    Educational  institu- 

30 


tions,  especially  State  universities,  have  here  a  duty  to 
perform.  If  university  extension  work  is  needed  in  lit- 
erature, science  and  agriculture,  how  much  more  is  it 
needed  in  practical  philanthropy. 

In  conclusion,  let  me  point  to  the  instructive  ex- 
perience of  England.  The  workhouses  of  England 
(which  correspond  to  our  almshouses)  are  kept  in  their 
perfect  condition  through  the  three  methods  which  I 
have  discussed— visitation  by  local  boards  of  visitors, 
inspection  by  State  officials,  and  centralized  legislative 
and  executive  control.  The  English  government  has 
found  that  none  of  these  methods  can  be  dispensed  with 
if  the  administration  of  its  workhouses  is  to  be  the  best 
possible.  It  has  found,  too,  that  a  more  and  more  cen- 
tralized system  of  control  of  workhouse  administration 
is  necessary;  and  this  I  believe  will  be  found  necessary 
also  in  this  country  in  order  to  correct  completely  the 
errors  and  abuses  in  the  management  of  our  county 
almshouses. 


31 


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